Presentation on theme: "Milwaukee, Wisconsin April 30 – May 2, 2007"— Presentation transcript:
1 Milwaukee, Wisconsin April 30 – May 2, 2007 Welcome to the RUG n’ Roll Midwest & Great Lakes Regional User Group for Cerner ClientsMilwaukee, WisconsinApril 30 – May 2, 2007
2 Interdisciplinary Teaching Records using PowerPlan Functionality Lynn Germanson, RN, BSNSenior Business Application AnalystClinical Documentation TeamAurora Health Care, Milwaukee, WILori Zareczny, RN, BSNBusiness Application AnalystClinical Documentation TeamAurora Health Care, Milwaukee, WI
3 ObjectivesDescribe the challenges of standardizing Teaching Record content across multiple disciplines and multiple facilities.Describe how Interdisciplinary Teaching Recordshave been interpreted by Aurora Health Care usingCerner PowerPlan functionality.Describe how Teaching Records have been built inthe electronic medical record for Aurora HealthCare facilities.
4 Who is Aurora Health Care? Integrated Delivery Network14 Hospitals ( beds)120+ Outpatient Clinics140+ Retail PharmaciesLong Term CareHome Health ServicesHospice ServicesLaboratory ServicesOne of the nation’s “Most Wired” hospitals in 2004, 2005 & 2006Private, non-profit, teaching organization:684 employed physicians3,200 physicians on staff25,000 employees$2.6 billion annual revenue0.5 million IP days/year2.3 million OP visits/year0.25 million ED visits/year0.3 million Home Care visits/ year5.6 million retail Rx/year
6 Diverse Hospital Mix 14 Hospitals Range from 40-600 beds Include rural community hospitals and metropolitan acute care hospitalsTeaching facilitiesNewly constructed and acquired facilitiesVarious levels of “Computerization”
7 Cerner Applications at Aurora Hospital “Core” systems implemented fromPatient Access (Registration & Scheduling)PowerChart Orders, Results, ChargesRadiology, Surgery, Emergency DeptInterfaces: Lab, Transcription, Dietary, Digital Imaging“Advanced” product implementations under wayPowerChart Office in Clinics (>75% done)Pharmacy (100% done)Multidisciplinary Clinical Documentation & eMAR (90% done)PowerPlans & INet (14% done)Teaching Records (1st site Go-Live Sept. 2007)Barcode Medication Administration (new)CPOE (7% done)
8 Teaching Record History . . .first there was paper, then there were. . .Online FORMS
9 Form Mimics Paper STOP! Ambulatory Surgery Teaching Record: First area to capture teaching in CernerForm developed to capture their specialized teachingPhysical Therapy/Occupational Therapy:Developed short list of common teaching topicsSpeech, Nutrition, Nursing Other Disciplines. . .Requested their “Own” teaching topicsSTOP!
13 Form Format? PROs Interdisciplinary Pulls LCV, so can see what was taught previouslyCustomized to list specific teaching materials givenCONsEach Topic requires 7 DTAsComplex Event Set HierarchyRequired teaching not identifiableUnable to individualizeGeneral Topics - Comment/note at bottom of page to be more specificMaintenance nightmareTeaching Records needed (>150)
18 PowerGrid FormatPROsUseful for areas seeing patient over extended period of time (several months) with focused topicsCan select multiple topics in one entryAllows individualization (comments)LCV pulls previous teaching, allowing review in formCONsLCV pulls previous teaching, so resign others’ data each timeSeveral topics identified in each visitConfusing to new care providerOne packed row vs. several rows in order to provide details about response to each topicInpatient build would be several forms with multiple sections because of variety of teaching topic groupersUnable to identify Required Components
20 . . . Incorporate >150 paper teaching records x 14 site variations using different formats into something that will be. . .InterdisciplinaryIndividualizedAddress Barriers to Learning for each learning sessionAddress components identified through evidence / regulatory standardsAllow easy review of previous chartingStandardized across a multi-hospital system
21 Teaching Records using PowerPlan Design System Interdisciplinary Groups met several times to decide:Diagnosis-based plans (CMS/Premier standards)Subcategories in each Diagnosis Teaching PlanRequired components to meet set standardsGrouper Headers for other topic categoriesTopic detail levelWhat is recorded about each topic – readiness, who, what, how, when, result
24 Conceptual Design - Subcategories in Diagnosis Teaching Plans
25 Subcategories in Diagnosis Teaching Plans Disease ConditionTests / ProceduresTreatmentsTherapy / EquipmentTreatmentMedication ManagementFunctional SkillsSafetySkillsAssistive DevicesNutritionGuidelinesDietWellnessAdvance DirectivesSmokingDischargeReview InstructionsHome MonitoringCommunity Resources / Home Care
26 Building Blocks Diagnosis-based Teaching Records Plans Composed of Subcategory “Building Blocks”Includes “Groupers” which exist independently for use without Diagnosis Teaching PlansDiagnosis-based Plans Subcategory GroupersDiagnosisDisease ConditionTests / ProceduresNutritionGuidelinesDietTreatmentsTherapy / EquipmentTreatmentWellnessAdvance DirectivesSmokingMedication ManagementDischargeReview InstructionsHome MonitoringCommunity Resources/Home CareFunctional SkillsSafetySkillsAssistive Devices
27 Using Cerner Functionality to Drive Teaching Record Format PlansTeaching Record category – “lives” after Discipline PlansTEACH prefix helps in Plan Search windowDocument In PlanInterventions not GoalsReady to LearnInitial or ReinforcementWho taughtMethod of instructionEvaluation of patient progressProgress to Teaching Completion
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